Provider Demographics
NPI:1851154710
Name:MISTRY, JINAL VATSAL (DMD)
Entity Type:Individual
Prefix:
First Name:JINAL
Middle Name:VATSAL
Last Name:MISTRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15219 BLUE MORNING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086-1140
Mailing Address - Country:US
Mailing Address - Phone:832-330-2929
Mailing Address - Fax:
Practice Address - Street 1:15219 BLUE MORNING DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-1140
Practice Address - Country:US
Practice Address - Phone:832-330-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program